EFFECT OF EXTENT OF ANTERIOR RESECTION AND SEX ON DISEASE-FREE SURVIVAL AND LOCAL RECURRENCE IN PATIENTS WITH RECTAL-CANCER

Results are presented following 119 curative resections for rectal can cer performed on 47 women and 72 men. Throughout the study it was poli cy to remove part of the female genital tract when the rectal tumour i mpinged on the uterus and/or the posterior vaginal wall. After a media n follow-up of 7.5 years, local recurrence occurred in three of 46 wom en and 15 of 71 men (P=0.03). The survival rates at 5 years were 71 pe r cent for women (95 per cent confidence interval 56-83 per cent) and 60 per cent for men (95 per cent confidence interval 50-71 per cent) ( P<0.05). The risk for distant metastasis was comparable, suggesting an influence of local recurrence on survival. Reduction of the local rec urrence rate coincides with the higher proportion of anterior extensio ns of surgery in women (19 of 47) than in men (two of 72).